Rosenstock L, Keifer M, Daniell W E, McConnell R, Claypoole K
Occupational Medicine Program, University of Washington, Seattle 98195.
Lancet. 1991 Jul 27;338(8761):223-7. doi: 10.1016/0140-6736(91)90356-t.
Acute organophosphate pesticide poisonings cause substantial morbidity and mortality world wide; however, whether organophosphates cause chronic neurological sequelae has not been established. To see whether single episodes of acute unintentional organophosphate intoxication lead to chronic neuropsychological dysfunction, we carried out a retrospective study of agricultural workers in Nicaragua who had been admitted to hospital between July 1, 1986, and July 31, 1988, for occupationally related organophosphate intoxication. This "poisoned" group (36 men) was tested on average about two years after the episode of pesticide poisoning and compared with a matched control group. The poisoned group did much worse than the control group on all neuropsychological subtests, with significantly worse performance on five of six subtests of a World Health Organisation neuropsychological test battery and on 3 of 6 additional tests that assessed verbal and visual attention, visual memory, visuomotor speed, sequencing and problem solving, and motor steadiness and dexterity. Differences in neuropsychological performance could not be explained by other factors. The findings of a persistent decrease in neuropsychological performance among individuals with previous intoxication emphasise the importance of prevention of even single episodes of organophosphate poisoning.
急性有机磷农药中毒在全球范围内导致大量发病和死亡；然而，有机磷是否会引起慢性神经后遗症尚未明确。为了探究急性非故意性有机磷中毒的单次发作是否会导致慢性神经心理功能障碍，我们对1986年7月1日至1988年7月31日期间因职业性有机磷中毒而入院的尼加拉瓜农业工人进行了一项回顾性研究。这个“中毒”组（36名男性）在农药中毒事件发生后平均约两年接受了测试，并与一个匹配的对照组进行了比较。在所有神经心理子测试中，中毒组的表现都比对照组差得多，在世界卫生组织神经心理测试组的六个子测试中的五个以及另外六个评估言语和视觉注意力、视觉记忆、视觉运动速度、排序和问题解决能力以及运动稳定性和灵活性的测试中的三个表现明显更差。神经心理表现的差异无法用其他因素来解释。先前中毒个体神经心理表现持续下降的研究结果强调了预防即使是单次有机磷中毒发作的重要性。
